Seizure Safety

Know How to Respond if Someone Has a Seizure

Witnessing a person having a seizure can be a scary experience if you don’t know what is happening or how to react.
Often seizures are caused by epilepsy, a common neurologic condition that involves recurrent, unprovoked seizures caused by a surge of abnormal electrical activity in the brain. This surge in brain activity causes symptoms that vary depending on which part of the brain is involved. If a seizure begins in the part of the brain controlling vision, it can cause visual hallucinations. In contrast, if a seizure begins in the part of the brain that controls smell, it can cause olfactory hallucinations or smelling scents that are not there.

The seizure most commonly seen on TV or in the movies—and the most obvious seizure type—is the generalized tonic-clonic seizure or convulsion (previously termed grand mal seizures). These seizures involve stiffening and straightening of the arms and legs—the tonic phase—followed by rhythmic shaking of the extremities—the clonic phase—often accompanied by tongue biting, le drooling, and confusion when the seizure stops. Seizure induced confusion typically lasts hours and the person often can’t recall the seizure. Seizures can also be much subtler and can, for instance, involve staring, loss of time, lip smacking, fumbling of the hands, a sense of déjà vu (the feeling that something is unusually familiar), or butterflies in the stomach

Tips for Seizure Safety

If a generalized tonic-clonic seizure occurs, it can be very scary for witnesses and can, in certain cases, be dangerous to the person having the seizure. If you witness a seizure, try to stay calm and keep track of how long the seizure lasts. Lay the person on their side in a flat area away from any dangers such as sharp objects or water. Avoid putting anything in their mouth and stay with them until the seizure is over. Remember, it may take several minutes for them to begin responding to you, and they may take hours to fully wake up, so stay with them until they are able to respond and are fully aware of their environment.

When to Call 911

  • If the tonic or clonic phases of a seizure last more than three minutes.
  • If two or more seizures occur without the patient regaining consciousness between episodes.
  • If the person stops breathing and does not begin breathing after the seizure.
  • If the person has never had a seizure before or if the seizure looks different from previous the person’s previous seizures.
  • If you witness a stranger having a seizure, assume this is their first seizure.
  • If the person has other conditions such as diabetes, a brain infection, pregnancy, known or suspected poisoning, or known or suspected alcohol or drug withdrawal or abuse.
  • If the person has had a head injury within days before the seizure.
  • If the person hits their head during a seizure and is difficult to arouse, vomits, or complains of blurred vision.
  • If the seizure occurs in water.

If you have had a generalized tonic-clonic seizure or any other seizure affecting your ability to interact with the environment, you should stop driving until cleared by a physician. In either instance, you should follow up with your primary care physician or neurologist. Brain injury, brain tumors, and stroke can cause seizures, so it is important to get a thorough work-up. A majority of people with epilepsy are simply prone to seizures and a clear cause for the seizure won’t be evident.

Post-Seizure Precautions

  • Avoid driving or operating heavy machinery
  • Avoid climbing to high heights. Be careful with ladders and step stools.
  • Avoid cooking over an open flame
  • Avoid baths unless an adult is present or another adult is in the home
  • Avoid swimming alone and use a life jacket in deep water
  • Any other activities that would be dangerous in the event of a seizure. If you have any concerns, clear these activities with your physician before attempting them.